Knowledge formation tools; empowering LGBTIQQ in Uganda to generate information for advocacy

Using Marxian political-economy analyses to identify and confront hardships to ART adherence in Africa

MARPs in Uganda a local NGO, embarked on synthesizing reports from all its activities and uses standard knowledge development methods. Under the program “structural barriers to ART adherence in the Global South,” one of the themes is the connection between knowledge, power and privilege affect access to HIV-related quality services in different domestic countries. In many of the countries, especially the global South, HIV prevalence reductions require comprehensive understanding of HIV prevention goals and import substitution and generic drug manufacture. Scholars points out that structural developments drive impacting change at national levels. State-led domestic industrialization policies allow for instance, drug manufacturing which in turn provides contexts in which people can access locally made medications. This is one example of how a national-scale policy helps influence social relations. The relations can be between places, social groups, cultures, spheres of production and consumption. Supply of ARVs and an HIV+ve diagnosis affect the connections to knowledge, power, its practice, material manifestation (property ownership and use) and life preserving practices (food supply, drug refills, nutrition support and eating habits) of those living with HIV. The priorities to access the right medicines or even food shifted power for HIV +ve persons. In this essay, I attempt to use both a primary descriptive analysis, literature review and a critical social theories to explain grounded struggles e.g. need for food, support networks, how to ensure one has medication, housing or necessary means for food supply. Marxian political-economy analyses have been used as lenses to figure out how an HIV+ve diagnosis plays out in structures and systems enabling or disabling capital accumulation and those impacting social relations of class, the role of the state, production systems and inherent coercive processes of HIV prevention.The fate of a person living with HIV in relation to ARV and other forms of support is impacted by different factors. The factors include identity, subjectivity, knowledge and power which constitute a political ecology in which an HIV +ve person is situated. Secondly, there is a contextual aspect of HIV prevention, e.g., clinical aspects surrounding adherence, switching between ART regimens or at policy level where targets are about keeping 21 million on treatment of which 919,000 are children. Social and geographical sense of location of subjects influence power relations and axes of identity. The right to health as defined in Article 12 of the International Covenant on Economic, Social and Cultural Rights is the right of everyone to the enjoyment of the highest attainable standard of physical and mental health. This includes the right of everyone, including people living with and affected by HIV, to the prevention and treatment of ill health, to make decisions about one’s own health and to be treated with respect and dignity and without discrimination.


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